自制冻干胶联羊膜在青光眼滤过术后抗瘢痕化作用的研究

发布时间：2018-05-24 23:46

本文选题：冻干胶联羊膜 + 青光眼　；参考：《华中科技大学》2011年博士论文

【摘要】：第一部分自制冻干胶联羊膜在兔眼滤过术后抗瘢痕化作用的研究目的：探讨冻干胶联羊膜在实验动物兔眼抗青光眼手术中的抗纤维化作用。方法：选择日本大白兔24只,随机分为3组：实验组滤过手术联合冻干胶联羊膜移植术组,对照组滤过手术联合胶联自然羊膜组,空白组单纯滤过手术组。分别与手术后7天,14天,21天,30天进行临床观察,HE染色,massion染色,a-SMA免疫组化进行组织病理学观查。应用实时定量逆转录聚合酶链式反应(RT-PCR)测其滤过区域的结缔组织生长因子(CTGF) mRNA的表达水平。结果：分别与手术后7天,14天,21天,30天进行临床观察,结膜充血及眼压有统计学意义；组织病理学分析(HE染色,massion染色,a-SMA免疫组化)进一步证实,滤过手术联合冻干胶联羊膜移植术组伤口愈合良好,有效减少瘢痕形成,有利于长期保证术后效果。定量逆转录聚合酶链式反应(RT-PCR)测其滤过区域的结缔组织生长因子(CTGF) mRNA的表达水平,各组在术后14天达到高峰,在实验的各个时间段CTGFmRNA的表达：实验组对照组空白组。结论：在我们的实验中,冻干胶联羊膜延长了滤过泡生存时间,减少了结膜充血程度,抑制了组织纤维化,在手术后一定程度降低了眼压。这种新材料可能常规用在青光眼滤过术中。第二部分自制冻干胶联羊膜缓释药膜在兔眼滤过术后抗瘢痕化作用的研究目的：探讨自制冻干胶联羊膜做为缓释药膜应用于兔眼滤过术后结膜瓣下,起到抗纤维化作用,延长滤过泡生存时间,降低术后眼内压(IOP),促进滤过术后伤口正常愈合。方法：选择日本大白兔24只,随机分为3组：实验组滤过手术联合结膜瓣下放置5-fu胶联冻干羊膜缓释药膜,对照组滤过手术联合结膜瓣下应用5-fu组,空白组单纯滤过手术组。分别与手术后7天,14天,21天,30天进行临床观察,HE染色,massion染色,a-SMA免疫组化进行组织病理学观查。高效液相(HPLC)色谱仪检测胶联羊膜5-Fu缓释药膜控释系统的兔眼内药代动力学情况。结果：分别与手术后7天,14天,21天,30天进行临床观察,结膜充血及眼压有统计学意义；组织病理学分析(HE染色,massion染色,a-SMA免疫组化)进一步证实,滤过手术联合冻干胶联羊膜缓释药膜移植术组伤口愈合良好,有效减少瘢痕形成,有利于长期保证术后效果。HPLC检测术后3天实验组组5-Fu释放量大于B组5-Fu释放量。5-FU能从缓释系统中缓慢释放,体内外释药平稳、高效,无突释现象。结论：在我们的实验中,冻干胶联联羊膜缓释药膜延长了滤过泡生存时间,抑制了结膜下组织瘢痕化程度,长时间的维持术后疗效,这种新材料可能应用在以后的青光眼滤过术中。
[Abstract]:Part one study on anti-scar effect of self-made freeze-dried gelatin-amniotic membrane in rabbit eye filtration surgery Objective: to investigate the anti-fibrosis effect of freeze-dried gelatine-amniotic membrane in rabbit eyes. Methods: Twenty-four Japanese white rabbits were randomly divided into three groups: the experimental group was treated by filtration surgery combined with freeze-dried glue and amniotic membrane transplantation group, the control group was treated with filtration surgery combined with natural amniotic membrane group, and the blank group was treated with pure filtration operation group. Clinical observation was carried out on the 7th day, 14th day, 21st day and 30th day after operation respectively. The histopathological observation was performed by immunohistochemical staining with HE staining massion staining and a-SMA staining. The expression of connective tissue growth factor (CTGF) mRNA in its filtered region was measured by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results: the conjunctival hyperemia and intraocular pressure were observed 7 days, 14 days and 21 days and 30 days after operation respectively. In the group of filtration surgery and freeze-dried glue combined with amniotic membrane transplantation, the wound healed well, the scar formation was effectively reduced, and the long-term effect was ensured. Quantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression level of connective tissue growth factor (CTGF) mRNA in the filtered region. The expression of CTGF mRNA in each group reached its peak on the 14th day after operation. The expression of CTGFmRNA in each time period of the experiment was as follows: the control group was blank group. Conclusion: in our experiment, freeze-dried amniotic membrane prolonged the survival time of filtering bleb, reduced the degree of conjunctival hyperemia, inhibited tissue fibrosis, and reduced intraocular pressure to some extent after operation. This new material may be routinely used in glaucoma filtration surgery. The second part: study on anti-scar effect of self-made freeze-dried gelatin-amniotic membrane sustained release drug membrane in rabbit eye filtration surgery Objective: to study the application of freeze-dried gel combined with amniotic membrane as sustained-release drug membrane under conjunctival flap of rabbit eye filtration, which can prevent fibrosis, prolong survival time of filtering bleb, reduce intraocular pressure (IOP), and promote wound healing after filtering operation. Methods: Twenty-four Japanese white rabbits were randomly divided into three groups: the experimental group was treated with filtration surgery and conjunctival flap placed 5-fu gel and freeze-dried amniotic membrane, the control group was treated with 5-fu under the conjunctival flap, and the control group was treated with filtration only. Clinical observation was carried out on the 7th day, 14th day, 21st day and 30th day after operation respectively. The histopathological observation was performed by immunohistochemical staining with HE staining massion staining and a-SMA staining. High performance liquid chromatography (HPLC) was used to detect the pharmacokinetics of 5-Fu sustained-release drug release system in rabbit eyes. Results: the conjunctival hyperemia and intraocular pressure were observed 7 days, 14 days and 21 days and 30 days after operation respectively. Filtration surgery combined with freeze-dried glue and amniotic membrane sustained release drug membrane transplantation group had good wound healing and effectively reduced scar formation. It was helpful to ensure the long-term effect. The 5-Fu release amount in experimental group was higher than that in group B on the 3rd day after operation. 5-FU was released slowly from the sustained release system, and the drug release in vivo and in vitro was stable, high efficiency and no sudden release. Conclusion: in our experiment, freeze-dried gel combined with amniotic membrane prolonged the survival time of filtration bleb, inhibited the degree of scar formation in subconjunctival tissue, and maintained the postoperative efficacy for a long time. This new material may be used in subsequent glaucoma filtration surgery.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R779.6

【共引文献】